5 Reasons Nurse Practitioners Get Fired (and How to Avoid Them)

Fortunately, most nurse practitioners don't need to think about getting the ax. Overall, we're a hard-working, devoted crowd that takes our jobs seriously. But, what if you and your employer don't see eye-to-eye about your performance? The truth is that as at-will employees we can be fired at any time. If you're following through on your responsibilities as an NP, this doesn't usually happen. But, let's look at the reasons it could - and talk about how to avoid these pitfalls.

1. Not Measuring Up to Expectations

By far, the most common reason I see nurse practitioners get the proverbial ax is for not measuring up to an employer's expectations. In some settings, this means the NP isn't working quickly enough, or meeting productivity measures. In others, it may mean that the employer is disappointed by the NP's lack of clinical knowledge in a certain area. For other employers, expectations may include patient satisfaction scores, with which the nurse practitioner is falling behind.

The Fix: As a nurse practitioner, the way you measure success may not equate to your employer's definition of achievement. Ask your employer what others in your role have done that have made them successful providers. Then, duplicate this behavior. Employers each place emphasis on different aspects of patient care and expect the nurse practitioners working for them to prioritize accordingly. Make sure you know what's important to your boss so you can deliver.

2. Unprofessional Behavior

Calling out, tardy arrivals, and similar professional snafus seriously disrupt patient care. Furthermore, unprofessional behaviors like poor communication with patients and staff also negatively affect the practice work environment and customer service a facility provides. So, it's understandable that nurse practitioners falling into such negative habits get fired.

The Fix: Avoid becoming lax in your role as a nurse practitioner. Follow protocol and the most basic expectations of your employer. Maintain a positive attitude in your workplace, even if this isn't the norm, so you standout as someone who contributes. Habitual lateness, absenteeism, and negativity are a drain on your coworkers and eventually someone will take note. Routinely seek feedback from your boss to make sure there aren't any areas where you could stand to improve.

3. Making Mistakes

Working in patient care is a major responsibility. A small mistake can have big implications (here's how to apologize). So, take your role as a clinician seriously and treat it carefully. As a nurse practitioner, you'll undoubtedly encounter clinical situations in which you aren't sure how to act. Seek the assistance you need rather than making a guess. Too many clinical mistakes could not only cost you your job, but also put a patient in harm's way. Most employers are willing to let one or two mishaps slide, but do something dangerous, or habitually make poor decisions, and you're likely to be shown the door.

The Fix: Seek out an employer than can offer the support required based on your level of experience. If you aren't sure about something, ask. Make certain you have the backup you need as a nurse practitioner, and know when to use it. Don't take chances.

4. Licensing Issues

Not only must nurse practitioners keep an employer happy, they must also comply with the Board of Nursing's demands. Neglecting to follow scope of practice or licensing guidelines can land you as an NP in poor favor with regulatory bodies. Once your license to practice is in jeopardy or has been revoked, your employer will probably give you the boot as well.

The Fix: Understand the scope of practice and licensing regulations for nurse practitioners practicing in your state. Routinely check to make sure your paperwork is in order to maintain compliance. If you're ever asked to practice outside of your scope, seek guidance from an authoritative body before proceeding.

5. Breaches of Conduct

The nurse practitioner profession falls under a number of authorities. The DEA, for example, influences nurse practitioner's prescribing abilities. Federal law and the regulations of payers like CMS may also impact the way nurse practitioners are allowed to practice. Breaching any of these guidelines, such as HIPAA, calls your quality as a nurse practitioner into question. Legal consequences may follow, and/or your employer may elect to break ties.

The Fix: Maintain compliance with the regulations that govern your practice as a nurse practitioner. If you aren't sure what these include, do a little research and ask around. If you work for a larger employer, they likely offer a handbook as a guide to get you started. It's your personal responsibility as a healthcare provider to know and understand the regulations you're subject to. Ignorance about these guidelines is never an excuse.